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WHA Letter to Delegation: Stabilize the Exchange Market

Wisconsin counties impacted by exchange instability

August 11, 2017

Even though the U.S. Senate failed to move legislation on repealing and replacing the Affordable Care Act, Wisconsin Hospital Association President/CEO Eric Borgerding wrote Wisconsin’s federal delegation about growing market instability in Wisconsin and that Congressional work is not done. 

“WHA and our members have relayed to you and your staff repeatedly in 2017 that affordable coverage on the exchange for lower-income individuals has been a key component of Wisconsin’s highly successful model of coverage expansion,” said Borgerding. “The vast majority of individuals (83 percent) on the exchange in Wisconsin for 2017 are eligible to receive premium assistance, with 51 percent, or 110,000 of 216,000 people also eligible to receive [Cost Sharing Reductions] CSRs. In other words, as go the exchanges, so goes the viability of Wisconsin’s coverage model.”

This past week California-based health insurance company Molina Healthcare announced it would abandon Wisconsin’s insurance exchange market, following Anthem and Health Tradition Health Plan that made similar announcements earlier this year. With the departure of these three insurers, 10 Wisconsin counties in 2018 will now only have one remaining insurer option and one county—Menominee—will have no option at all on the exchange. Included with the letter were three WHA-developed statewide maps reflecting county-by-county coverage changes to date. (See WHA’s August 4 article for more details.)

Instability in the market is increasing, in part, due to the uncertainty about CSRs, as those have been integral in making coverage affordable. WHA continues to advocate that Congress and the administration fund the CSRs.

“The National Governors Association Health Committee statement put it well when it urged the administration to ‘fully fund CSRs for the remainder of calendar year 2017 through 2018.’ Congress should support this action as a necessary step to ‘stabilize the individual marketplaces in the short term as Congress and the administration address long-term reform efforts.’ WHA agrees,” said Borgerding. 

“Wisconsin has much at stake in what comes next, and something must come next in order to protect people and stabilize the markets. Inaction is not an option nor is intentionally allowing failure of insurance markets an acceptable strategy or outcome.”

This story originally appeared in the August 11, 2017 edition of WHA Newsletter